Department of Urology, Beaumont Health System, Royal Oak, MI, USA; Oakland University William Beaumont School of Medicine, Rochester Hills, MI, USA.
Detroit Medical Center, Detroit, MI, USA; John D. Dingell VA Medical Center, Detroit, MI, USA.
Med Hypotheses. 2020 Dec;145:110375. doi: 10.1016/j.mehy.2020.110375. Epub 2020 Nov 5.
Coronavirus disease 2019 (COVID-19) causes a wide range of symptoms, including several unexpected symptoms such as loss of taste, skin changes, and eye problems. We recently observed patients with documented COVID-19 develop de novo severe genitourinary symptoms, most notably urinary frequency of ≥ 13 episodes/24 h and nocturia ≥ 4 episodes/night. We call these associated urinary symptoms COVID-19 associate cystitis (CAC). COVID-19 severity is associated with inflammation. We collected urine samples from COVID-19 patients, including patients with CAC, and found elevation of proinflammatory cytokines also in the urine. It has been previously shown that patients with urinary incontinence and ulcerative interstitial cystitis/bladder pain syndrome have elevated urinary inflammatory cytokines compared to normal controls. We therefore hypothesize that CAC, with presentation of de novo severe urinary symptoms, can occur in COVID-19 and is caused by increased inflammatory cytokines that are released into the urine and/or expressed in the bladder. The most important implications of our hypothesis are: 1) Physician caring for COVID-19 patients should be aware of COVID-19 associate cystitis (CAC); 2) De novo urinary symptoms should be included in the symptom complex associated with COVID-19; and 3) COVID-19 inflammation may result in bladder dysfunction.
新型冠状病毒病 2019（COVID-19）可引起多种症状，包括一些意想不到的症状，如味觉丧失、皮肤变化和眼部问题。我们最近观察到有记录的 COVID-19 患者出现新发严重的泌尿生殖系统症状，最明显的是≥13 次/24 小时的尿频和≥4 次/夜的夜尿症。我们将这些相关的泌尿症状称为 COVID-19 相关膀胱炎（CAC）。COVID-19 的严重程度与炎症有关。我们从 COVID-19 患者（包括 CAC 患者）中收集了尿液样本，发现尿液中促炎细胞因子也升高。以前已经表明，与正常对照组相比，患有尿失禁和溃疡性间质性膀胱炎/膀胱疼痛综合征的患者尿液中促炎细胞因子升高。因此，我们假设 CAC 以新发严重的泌尿症状为特征，可能发生在 COVID-19 中，并由释放到尿液中和/或在膀胱中表达的增加的炎症细胞因子引起。我们假设的最重要意义在于：1）照顾 COVID-19 患者的医生应该意识到 COVID-19 相关膀胱炎（CAC）；2）新发的泌尿症状应包括在与 COVID-19 相关的症状综合中；3）COVID-19 炎症可能导致膀胱功能障碍。
